Hybrid Imaging in Medicine (Closed)

A topical collection in Diagnostics (ISSN 2075-4418). This collection belongs to the section "Medical Imaging and Theranostics".

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Editors

Department of Clinical Physiology, Nuclear Medicine & PET National University Hospital, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Interests: molecular imaging; medical imaging; theranostics; targeted radionuclide therapy; cancer; cardiovascular disease; PET; SPECT; PET/MR
Special Issues, Collections and Topics in MDPI journals
Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London, St. Thomas’ Hospital, London, UK
Interests: [18F]NaF PET; bone metabolism; metastatic bone diseases; metabolic bone diseases; image analysis; radiomics; artificial intelligence
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

Medical imaging techniques are of paramount value in clinical medicine and as research tools. The techniques are rapidly improving and new techniques are continuously implemented. Whereas every technique has advantages and shortcomings, imaging techniques are often complementary, and therefore, a current trend is the integration of different imaging techniques for hybrid imaging. Examples of such synergistic hybrid imaging is PET/CT, which is now more common than PET-only scans. Recently, hybrid PET/MRI scanners have also been introduced in clinical use. Moreover, developments for combining ultrasonography with other modalities are on their way. Integration of morphological and functional imaging seems to be especially useful. However, combinations of several functional modalities may add value and allow for better tissue characterization.

This collection invites submission of both original and review papers within all aspects of hybrid imaging.

Prof. Dr. Andreas Kjaer
Collection Editor

Manuscript Submission Information

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Keywords

  • positron emission tomography
  • computed tomography (CT)
  • magnetic resonsnace imaging (MRI)
  • magnetic resonance spectroscopy (MRS)
  • ultrasonography
  • optical imaging
  • fluorescence
  • bioluminiscence
  • PET/CT
  • PET/MRI

Published Papers (20 papers)

2022

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22 pages, 3904 KiB  
Article
The Role of Nuclear Medicine Imaging with 18F-FDG PET/CT, Combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT in the Evaluation of Patients with Chronic Problems after TKA or THA in a Prospective Study
by Ramune Aleksyniene, Victor Iyer, Henrik Christian Bertelsen, Majbritt Frost Nilsson, Vesal Khalid, Henrik Carl Schønheyder, Lone Heimann Larsen, Poul Torben Nielsen, Andreas Kappel, Trine Rolighed Thomsen, Jan Lorenzen, Iben Ørsted, Ole Simonsen, Peter Lüttge Jordal and Sten Rasmussen
Diagnostics 2022, 12(3), 681; https://doi.org/10.3390/diagnostics12030681 - 10 Mar 2022
Cited by 5 | Viewed by 2775
Abstract
Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with 18F-FDG PET/CT (FDG PET/CT), combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee [...] Read more.
Background: The aim of this prospective study was to assess the diagnostic value of nuclear imaging with 18F-FDG PET/CT (FDG PET/CT), combined 111In-WBC/99mTc-Nanocoll, and 99mTc-HDP SPECT/CT (dual-isotope WBC/bone marrow scan) for patients with chronic problems related to knee or hip prostheses (TKA or THA) scheduled by a structured multidisciplinary algorithm. Materials and Methods: Fifty-five patients underwent imaging with 99mTc–HDP SPECT/CT (bone scan), dual-isotope WBC/bone marrow scan, and FDG PET/CT. The final diagnosis of prosthetic joint infection (PJI) and/or loosening was based on the intraoperative findings and microbiological culture results and the clinical follow-up. Results: The diagnostic performance of dual-isotope WBC/bone marrow SPECT/CT for PJI showed a sensitivity of 100% (CI 0.74–1.00), a specificity of 97% (CI 0.82–1.00), and an accuracy of 98% (CI 0.88–1.00); for PET/CT, the sensitivity, specificity, and accuracy were 100% (CI 0.74–1.00), 71% (CI 0.56–0.90), and 79% (CI 0.68–0.93), respectively. Conclusions: In a standardized prospectively scheduled patient group, the results showed highly specific performance of combined dual-isotope WBC/bone marrow SPECT/CT in confirming chronic PJI. FDG PET/CT has an appropriate accuracy, but the utility of its use in the clinical diagnostic algorithm of suspected PJI needs further evidence. Full article
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2021

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12 pages, 1891 KiB  
Article
The Assessment of the Usefulness of Prenatal Magnetic Resonance Imaging in the Diagnosis of Central Nervous System Defects
by Magdalena Kołak, Izabela Herman-Sucharska, Małgorzata Radoń-Pokracka, Małgorzata Stolarek, Anna Horbaczewska and Hubert Huras
Diagnostics 2021, 11(9), 1723; https://doi.org/10.3390/diagnostics11091723 - 20 Sep 2021
Cited by 1 | Viewed by 1637
Abstract
Central nervous system (CNS) abnormalities cause about 40% of infant deaths in the first year of life. In case of the detection of abnormalities by ultrasound, a pregnant woman should be offered prenatal magnetic resonance imaging (pMRI). The aims of our study were: [...] Read more.
Central nervous system (CNS) abnormalities cause about 40% of infant deaths in the first year of life. In case of the detection of abnormalities by ultrasound, a pregnant woman should be offered prenatal magnetic resonance imaging (pMRI). The aims of our study were: (1) to evaluate the effectiveness of pMRI in the diagnosis of selected fetal CNS defects; and (2) to assess the possibility of replacing postnatal tests with prenatal magnetic resonance. The prospective and observational study was conducted between 2014 and 2017 at the University Hospital in Krakow. Patients with suspected CNS defects of the fetus were qualified for pMRI in the third trimester of pregnancy. Sixty patients were included in the study group. Prenatal MRI was characterized by low accuracy in the diagnosis of complex brain defects. Cohen’s kappa coefficient κ = 0.21 (95% CI 0.00–0.46). No evidence was found suggesting the replacement of postnatal tests with pMRI. MRI was characterized by low consistency of diagnoses in the case of complex brain defects. The possibility of replacing postnatal studies with pMRI was not supported. Full article
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16 pages, 4378 KiB  
Review
18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis
by Giuseppina Biscontini, Cinzia Romagnolo, Chiara Cottignoli, Andrea Palucci, Fabio Massimo Fringuelli, Carmelo Caldarella, Francesco Ceci and Luca Burroni
Diagnostics 2021, 11(2), 304; https://doi.org/10.3390/diagnostics11020304 - 13 Feb 2021
Cited by 9 | Viewed by 1984
Abstract
Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred [...] Read more.
Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were “PET” or “positron emission tomography” or “positron emission tomography/computed tomography” or “PET/CT” or “positron emission tomography-computed tomography” or “PET-CT” and “Fluciclovine” or “FACBC” and “prostatic neoplasms” or “prostate cancer” or “prostate carcinoma”. Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible. Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80–0.86), the specificity of 0.77 (95% CI: 0.74–0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39–0.73) and specificity of 0.99 (95% CI: 0.94–1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63–0.73), and specificity of 0.68 (95% CI: 0.60–0.75). Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results. Full article
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2020

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6 pages, 694 KiB  
Communication
Interrater Reliability of 99mTc-DMSA Scintigraphy Performed as Planar Scan vs. SPECT/Low Dose CT for Diagnosing Renal Scarring in Children
by Hrefna Sæunn Einarsdóttir, Ronan Martin Griffin Berg and Lise Borgwardt
Diagnostics 2020, 10(12), 1101; https://doi.org/10.3390/diagnostics10121101 - 17 Dec 2020
Cited by 6 | Viewed by 3925
Abstract
99mTc-dimercaptosuccinic acid (DMSA) scintigraphy is currently the method of choice for assessing renal scarring in children, but it is not established whether conducting the scan as a single photon emission tomography combined with low-dose CT (SPECT/ldCT) scan provides additional diagnostic benefits when [...] Read more.
99mTc-dimercaptosuccinic acid (DMSA) scintigraphy is currently the method of choice for assessing renal scarring in children, but it is not established whether conducting the scan as a single photon emission tomography combined with low-dose CT (SPECT/ldCT) scan provides additional diagnostic benefits when compared to conventional planar scintigraphy. In the present study, we evaluated the interrater reliability of DMSA SPECT/ldCT vs. planar DMSA scintigraphy for diagnosing renal scarring. Methods: Two nuclear medicine physicians blinded to patient data retrospectively analysed all paediatric 99mTc-DMSA scintigraphes that were conducted in our department for the assessment of post pyelonephritis renal scarring between 2011 and 2016. All scintigraphies included both a planar scan and SPECT/ldCT, and were performed on either a Phillips Precedence 16 slice CT or a Siemens Symbia 16 slice CT. The readers were blinded to each other’s readings and to patient data, and assessed all scans dichotomously for evidence of renal scarring. For each scan, the readers further noted if they were confident in their interpretation. Results: A total of 46 pairs of planar SPECT/ldCT DMSA scans were included. The readers were unconfident about their interpretation of 40% of the planar scans and 5% of the SPECT/ldCT scans. The interrater agreement rate was 72% for planar scans and 91% for SPECT/ldCT, and the corresponding Cohen’s kappa values were 0.38 and 0.79. Conclusion: DMSA SPECT/ldCT is associated with higher reader confidence and interrater reliability than conventional planar DMSA scintigraphy for the assessment of post pyelonephritis renal scarring in children. Full article
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2019

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10 pages, 2515 KiB  
Protocol
A New Diagnostic Approach for Periprosthetic Acetabular Fractures Based on 3D Modeling: A Study Protocol
by Giuseppe Marongiu, Roberto Prost and Antonio Capone
Diagnostics 2020, 10(1), 15; https://doi.org/10.3390/diagnostics10010015 - 29 Dec 2019
Cited by 6 | Viewed by 6151
Abstract
Periprosthetic acetabular fractures after total hip arthroplasty (THA) are mostly related to low energy trauma reduced bone quality. CT-scan is widely used to evaluate acetabular fractures, however, metal artifacts produced prosthetic implants limit the visualization of the articular surface and bone loss assessment. [...] Read more.
Periprosthetic acetabular fractures after total hip arthroplasty (THA) are mostly related to low energy trauma reduced bone quality. CT-scan is widely used to evaluate acetabular fractures, however, metal artifacts produced prosthetic implants limit the visualization of the articular surface and bone loss assessment. 3D modeling software allows us to creating tridimensional images of the bony surface, removing the metallic implants trough image segmentation. We highlight the use of 3D modeling and rapid prototyping (3D printing) for the diagnostic process of periprosthetic acetabular fracture around THA. 3D modeling software was used to improve the assessment of fracture morphology and bone quality. Moreover, the 3D images were printed in a real-life size model and used for preoperative implant templating, sizing and surgical simulation. Full article
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2018

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3 pages, 315 KiB  
Interesting Images
18F-FDG PET/CT Findings in Cytomegalovirus Colitis
by Anna Sophie L. Kjaer, Iben Ribberholt, Kim Thomsen, Per H. Ibsen, Elena Markova and Jesper Graff
Diagnostics 2019, 9(1), 3; https://doi.org/10.3390/diagnostics9010003 - 26 Dec 2018
Cited by 5 | Viewed by 5184
Abstract
We present a case demonstrating the diagnostic work-up of a patient undergoing azathioprine treatment for inflammatory bowel disease (IBD), diagnosed with an acute cytomegalovirus (CMV) infection and CMV colitis. An 18F-FDG positron emission tomography/computed tomography (PET/CT) performed 2 weeks after debut of [...] Read more.
We present a case demonstrating the diagnostic work-up of a patient undergoing azathioprine treatment for inflammatory bowel disease (IBD), diagnosed with an acute cytomegalovirus (CMV) infection and CMV colitis. An 18F-FDG positron emission tomography/computed tomography (PET/CT) performed 2 weeks after debut of symptoms revealed pathological 18F-FDG uptake in the left side of the colon mucosa, mimicked activity of IBD. However, a diagnosis of CMV colitis was based on the presence of CMV IgM antibodies, a seroconversion of CMV IgG antibodies, presence of CMV DNA in plasma and the finding af CMV DNA in biopsies from the intestinal mucosa. The patient responded to treatment with ganciclovir. This case highlights that a positive 18F-FDG PET/CT scan of the colon can be due to CMV colitis. Full article
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2017

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738 KiB  
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18F-FDG PET/CT Findings in a Patient with Chikungunya Virus Infection
by Michala Vaaben Rose, Anna Sophie L. Kjaer, Elena Markova and Jesper Graff
Diagnostics 2017, 7(3), 49; https://doi.org/10.3390/diagnostics7030049 - 25 Aug 2017
Cited by 3 | Viewed by 6318
Abstract
We present a case demonstrating the diagnostic work-up and follow-up of a patient with Chikungunya infection. An 18F-FDG PET/CT performed four weeks after debut of symptoms revealed pathological 18F-FDG uptake in enlarged lymph nodes on both side of the diaphragm, and [...] Read more.
We present a case demonstrating the diagnostic work-up and follow-up of a patient with Chikungunya infection. An 18F-FDG PET/CT performed four weeks after debut of symptoms revealed pathological 18F-FDG uptake in enlarged lymph nodes on both side of the diaphragm, and inflammation of both shoulder and hip joints. Lymphoma and infection were the main differential diagnoses. Follow-up 18F-FDG PET/CT scan in the patient performed 14 weeks after the abnormal scan, revealed almost complete resolution of the metabolically active disease. This case is to our knowledge the first to demonstrate sequential 18F-FDG PET/CT scan results in a patient with Chikungunya virus infection. Full article
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2016

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1367 KiB  
Review
Dynamic Contrast-Enhanced CT in Patients with Pancreatic Cancer
by Rie Ø. Eriksen, Louise S. Strauch, Michael Sandgaard, Thomas S. Kristensen, Michael B. Nielsen and Carsten A. Lauridsen
Diagnostics 2016, 6(3), 34; https://doi.org/10.3390/diagnostics6030034 - 06 Sep 2016
Cited by 7 | Viewed by 6935
Abstract
The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane [...] Read more.
The aim of this systematic review is to provide an overview of the use of Dynamic Contrast-enhanced Computed Tomography (DCE-CT) in patients with pancreatic cancer. This study was composed according to the PRISMA guidelines 2009. The literature search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science databases to identify all relevant publications. The QUADAS-2 tool was implemented to assess the risk of bias and applicability concerns of each included study. The initial literature search yielded 483 publications. Thirteen articles were included. Articles were categorized into three groups: nine articles concerning primary diagnosis or staging, one article about tumor response to treatment, and three articles regarding scan techniques. In exocrine pancreatic tumors, measurements of blood flow in eight studies and blood volume in seven studies were significantly lower in tumor tissue, compared with measurements in pancreatic tissue outside of tumor, or normal pancreatic tissue in control groups of healthy volunteers. The studies were heterogeneous in the number of patients enrolled and scan protocols. Perfusion parameters measured and analyzed by DCE-CT might be useful in the investigation of characteristic vascular patterns of exocrine pancreatic tumors. Further clinical studies are desired for investigating the potential of DCE-CT in pancreatic tumors. Full article
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5653 KiB  
Communication
18F-FET-PET in Primary Hyperparathyroidism: A Pilot Study
by Martin Krakauer, Andreas Kjaer and Finn N. Bennedbæk
Diagnostics 2016, 6(3), 30; https://doi.org/10.3390/diagnostics6030030 - 17 Aug 2016
Cited by 8 | Viewed by 6388
Abstract
Preoperative localisation of the diseased parathyroid gland(s) in primary hyperparathyroidism (PHP) is a prerequisite for subsequent minimally invasive surgery. Recently, as alternatives to conventional sestamibi parathyroid scintigraphy, the 11C-based positron emission tomography (PET) tracers methionine and choline have shown promise for this [...] Read more.
Preoperative localisation of the diseased parathyroid gland(s) in primary hyperparathyroidism (PHP) is a prerequisite for subsequent minimally invasive surgery. Recently, as alternatives to conventional sestamibi parathyroid scintigraphy, the 11C-based positron emission tomography (PET) tracers methionine and choline have shown promise for this purpose. We evaluated the feasibility of using the 18F-based PET tracer fluoroethyl-l-tyrosine (FET), as the longer half-life of 18F makes it logistically more favourable. As a proof-of-concept study, we included two patients with PHP in which dual-isotope parathyroid subtraction single photon emission computed tomography had determined the exact location of the parathyroid adenoma. A dynamic FET PET/CT scan was performed with subsequent visual evaluation and calculation of target-to-background (TBR; parathyroid vs. thyroid). The maximum TBR in the two patients under study was achieved approximately 30 min after the injection of the tracer and was 1.5 and 1.7, respectively. This ratio was too small to allow for confident visualisation of the adenomas. FET PET/CT seems not feasible as a preoperative imaging modality in PHP. Full article
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Potential Pitfalls on the 99mTc-Mebrofenin Hepatobiliary Scintigraphy in a Patient with Biliary Atresia Splenic Malformation Syndrome
by Jane Maestri Brittain and Lise Borgwardt
Diagnostics 2016, 6(1), 5; https://doi.org/10.3390/diagnostics6010005 - 07 Jan 2016
Cited by 43 | Viewed by 5817
Abstract
Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of [...] Read more.
Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation. The 99mTc-Mebrofenin hepatobiliary scintigraphy is part of the diagnostic strategy when an infant presents jaundice due to conjugated hyperbilirubinemia (>20 µmol/L total bilirubin of which 20% is conjugated) with its high sensitivity of 97%–100% in refuting BA. Rapid extraction of tracer by the liver and no visible tracer in the small bowl after 24 h is indicative of BA. Laparotomy with antegrade cholangiography is then performed giving the final diagnosis when the remains of the obliterated biliary tree are revealed in the case of BA. We present a case demonstrating some of the challenges of interpreting the 99mTc-Mebrofenin hepatobiliary scintigraphy in an infant with BASM and stress the importance that the 99mTc-Mebrofenin hepatobiliary scintigraphy is part of a spectrum of imaging modalities in diagnosing BA. Full article
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2015

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704 KiB  
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Angiosarcoma of the Scalp: Metastatic Pulmonary Cystic Lesions Initially Misinterpreted as Benign Findings on 18F-FDG PET/CT
by Kim Francis Andersen, Elisabeth Albrecht-Beste, Anne Kiil Berthelsen and Annika Loft
Diagnostics 2016, 6(1), 1; https://doi.org/10.3390/diagnostics6010001 - 22 Dec 2015
Cited by 7 | Viewed by 6419
Abstract
Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with [...] Read more.
Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported five-year survival is <30%. The mainstay of treatment is surgical resection and adjuvant radiation therapy, but failure rates following local therapy are high. Cutaneous angiosarcoma of the scalp has a predilection for pulmonary metastases with a variety of morphologic patterns on imaging. Metastatic disease in terms of pulmonary thin-walled, cystic lesions, may not be hypermetabolic on 18F-FDG PET and, as such, could be misinterpreted as benign findings. We present a case demonstrating the diagnostic uncertainty and delay in an elderly male with angiosarcoma of the scalp presenting with metastatic lung lesions following failure of local therapy. Full article
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1753 KiB  
Review
Role of Hybrid Brain Imaging in Neuropsychiatric Disorders
by Amer M. Burhan, Nicole M. Marlatt, Lena Palaniyappan, Udunna C. Anazodo and Frank S. Prato
Diagnostics 2015, 5(4), 577-614; https://doi.org/10.3390/diagnostics5040577 - 04 Dec 2015
Cited by 11 | Viewed by 9498
Abstract
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional [...] Read more.
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional changes that have been observed in neuropsychiatric disorders. An overview of clinical hybrid brain imaging technologies for human use is followed by a selective review of the literature that conceptualizes the use of these technologies in understanding basic mechanisms of major neuropsychiatric disorders and their therapeutics. Neuronal network abnormalities are highlighted throughout this review to scope the utility of hybrid imaging as a potential biomarker for each disorder. Full article
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Pelvic Actinomycosis Associated with an Intrauterine Contraceptive Device Demonstrated on F-18 FDG PET/CT
by Danijela Dejanović, Jan Anders Ahnlide, Cecilia Nilsson, Anne Kiil Berthelsen and Annika Loft
Diagnostics 2015, 5(3), 369-371; https://doi.org/10.3390/diagnostics5030369 - 28 Aug 2015
Cited by 3 | Viewed by 6146
Abstract
A 44-year-old woman with a history of dysmenorrhea, obstipation, and low back pain was investigated for gynecological disorder. Physical examination indicated a “frozen pelvis”. Ultrasound examination revealed the ovaries adherent to the uterus, bilateral ovarian cysts, and an intrauterine contraceptive device in situ [...] Read more.
A 44-year-old woman with a history of dysmenorrhea, obstipation, and low back pain was investigated for gynecological disorder. Physical examination indicated a “frozen pelvis”. Ultrasound examination revealed the ovaries adherent to the uterus, bilateral ovarian cysts, and an intrauterine contraceptive device in situ, which reportedly had been in place for 19 years. Prior to a scheduled laparoscopy, the patient returned with oedema of the lower abdomen and legs, fatigue, and weight loss. Laboratory findings included elevated CA-125, anemia, leucocytosis and high C-reactive protein. Pelvic actinomycosis was subsequently diagnosed. We report the PET/CT appearance of this condition. Full article
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4938 KiB  
Review
PET/MRI in Oncological Imaging: State of the Art
by Usman Bashir, Andrew Mallia, James Stirling, John Joemon, Jane MacKewn, Geoff Charles-Edwards, Vicky Goh and Gary J. Cook
Diagnostics 2015, 5(3), 333-357; https://doi.org/10.3390/diagnostics5030333 - 21 Jul 2015
Cited by 37 | Viewed by 10566
Abstract
Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, and [...] Read more.
Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. Compared with CT, MRI is advantageous due to its lack of ionizing radiation, superior soft-tissue contrast resolution, and wider range of acquisition sequences. Several studies have shown PET/MRI to be equivalent to PET/CT in most oncological applications, possibly superior in certain body parts, e.g., head and neck, pelvis, and in certain situations, e.g., cancer recurrence. This review will update the readers on recent advances in PET/MRI technology and review key literature, while highlighting the strengths and weaknesses of PET/MRI in cancer imaging. Full article
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Review
Hybrid Imaging for Patient-Specific Dosimetry in Radionuclide Therapy
by Michael Ljungberg and Katarina Sjögreen Gleisner
Diagnostics 2015, 5(3), 296-317; https://doi.org/10.3390/diagnostics5030296 - 10 Jul 2015
Cited by 17 | Viewed by 7619
Abstract
Radionuclide therapy aims to treat malignant diseases by systemic administration of radiopharmaceuticals, often using carrier molecules such as peptides and antibodies. The radionuclides used emit electrons or alpha particles as a consequence of radioactive decay, thus leading to local energy deposition. Administration to [...] Read more.
Radionuclide therapy aims to treat malignant diseases by systemic administration of radiopharmaceuticals, often using carrier molecules such as peptides and antibodies. The radionuclides used emit electrons or alpha particles as a consequence of radioactive decay, thus leading to local energy deposition. Administration to individual patients can be tailored with regards to the risk of toxicity in normal organs by using absorbed dose planning. The scintillation camera, employed in planar imaging or single-photon emission computed tomography (SPECT), generates images of the spatially and temporally varying activity distribution. Recent commercially available combined SPECT and computed tomography (CT) systems have dramatically increased the possibility of performing accurate dose planning by using the CT information in several steps of the dose-planning calculation chain. This paper discusses the dosimetry chain used for individual absorbed-dose planning and highlights the areas where hybrid imaging makes significant contributions. Full article
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Brown Tumors Due to Primary Hyperparathyroidism in a Patient with Parathyroid Carcinoma Mimicking Skeletal Metastases on 18F-FDG PET/CT
by Kim Francis Andersen and Elisabeth Albrecht-Beste
Diagnostics 2015, 5(3), 290-293; https://doi.org/10.3390/diagnostics5030290 - 09 Jul 2015
Cited by 9 | Viewed by 5816
Abstract
Parathyroid carcinoma only represents <1% of all cases of primary hyperparathyroidism (PHPT). Even rare, chronic PHPT may lead to excessive osteoclast activity, and the increased resorption leads to destruction of cortical bone and formation of fibrous cysts with deposits of hemosiderin—so-called brown tumors. [...] Read more.
Parathyroid carcinoma only represents <1% of all cases of primary hyperparathyroidism (PHPT). Even rare, chronic PHPT may lead to excessive osteoclast activity, and the increased resorption leads to destruction of cortical bone and formation of fibrous cysts with deposits of hemosiderin—so-called brown tumors. These benign, osteolytic lesions may demonstrate FDG-avidity on 18F-FDG PET/CT, and as such are misinterpreted as skeletal metastases. Regression of the lesions may occur following successful treatment. We present a case demonstrating the diagnostic work-up and follow-up of a patient with PHPT due to parathyroid carcinoma and with presence of brown tumors on 18F-FDG PET/CT, visualizing the possible role of this imaging modality in the evaluation of treatment response in these patients. Full article
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In Vivo Phenotyping of Tumor Metabolism in a Canine Cancer Patient with Simultaneous 18F-FDG-PET and Hyperpolarized 13C-Pyruvate Magnetic Resonance Spectroscopic Imaging (hyperPET): Mismatch Demonstrates that FDG may not Always Reflect the Warburg Effect
by Henrik Gutte, Adam E. Hansen, Majbrit M.E. Larsen, Sofie Rahbek, Helle H. Johannesen, Jan Ardenkjaer-Larsen, Annemarie T. Kristensen, Liselotte Højgaard and Andreas Kjaer
Diagnostics 2015, 5(3), 287-289; https://doi.org/10.3390/diagnostics5030287 - 26 Jun 2015
Cited by 9 | Viewed by 5857
Abstract
In this communication the mismatch between simultaneous 18F-FDG-PET and a 13C-lactate imaging (hyperPET) in a biopsy verified squamous cell carcinoma in the right tonsil of a canine cancer patient is shown. The results demonstrate that 18F-FDG-PET may not always reflect [...] Read more.
In this communication the mismatch between simultaneous 18F-FDG-PET and a 13C-lactate imaging (hyperPET) in a biopsy verified squamous cell carcinoma in the right tonsil of a canine cancer patient is shown. The results demonstrate that 18F-FDG-PET may not always reflect the Warburg effect in all tumors. Full article
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2014

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2044 KiB  
Article
The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma
by Andreas Hjelm Brandt, Caroline Ewertsen and Kristoffer Lindskov Hansen
Diagnostics 2014, 4(3), 129-139; https://doi.org/10.3390/diagnostics4030129 - 10 Sep 2014
Cited by 16 | Viewed by 10277
Abstract
A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic blood [...] Read more.
A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic blood flow can be seen in the arterial phase near the liver lesion. The objective of this study was to describe THAD and PS/AF on follow-up CT after blunt liver trauma, and to evaluate if THAD influenced the evaluation of PS/AF. Three radiology residents retrospectively evaluated scans of 78 patients. The gold standard for PS/AF was an evaluation by an experienced senior radiologist, while THAD was a consensus between the residents. PS/AF was present in 14% and THAD in 54%. THAD was located in the periphery of the lesion with hazy borders and mean HU levels of 100, while PS/AF was located within the lesion with focal enhancement and mean HU levels of 170 (p < 0.05). In evaluation of PS/AF, the likelihood of agreement between the observers and the gold standard was 89% when THAD was present, and 98% when THAD was absent (p = 0.04). THAD is common and can hamper the evaluation of PS/AF. Full article
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1004 KiB  
Review
Endoscopic Optical Coherence Tomography for Clinical Gastroenterology
by Tsung-Han Tsai, James G. Fujimoto and Hiroshi Mashimo
Diagnostics 2014, 4(2), 57-93; https://doi.org/10.3390/diagnostics4020057 - 05 May 2014
Cited by 60 | Viewed by 11650
Abstract
Optical coherence tomography (OCT) is a real-time optical imaging technique that is similar in principle to ultrasonography, but employs light instead of sound waves and allows depth-resolved images with near-microscopic resolution. Endoscopic OCT allows the evaluation of broad-field and subsurface areas and can [...] Read more.
Optical coherence tomography (OCT) is a real-time optical imaging technique that is similar in principle to ultrasonography, but employs light instead of sound waves and allows depth-resolved images with near-microscopic resolution. Endoscopic OCT allows the evaluation of broad-field and subsurface areas and can be used ancillary to standard endoscopy, narrow band imaging, chromoendoscopy, magnification endoscopy, and confocal endomicroscopy. This review article will provide an overview of the clinical utility of endoscopic OCT in the gastrointestinal tract and of recent achievements using state-of-the-art endoscopic 3D-OCT imaging systems. Full article
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1435 KiB  
Article
Development of a Hybrid Nanoprobe for Triple-Modality MR/SPECT/Optical Fluorescence Imaging
by Renata Madru, Pontus Svenmarker, Christian Ingvar, Freddy Ståhlberg, Stefan-Andersson Engels, Linda Knutsson and Sven-Erik Strand
Diagnostics 2014, 4(1), 13-26; https://doi.org/10.3390/diagnostics4010013 - 10 Mar 2014
Cited by 20 | Viewed by 7133
Abstract
Hybrid clinical imaging is an emerging technology, which improves disease diagnosis by combining already existing technologies. With the combination of high-resolution morphological imaging, i.e., MRI/CT, and high-sensitive molecular detection offered by SPECT/PET/Optical, physicians can detect disease progression at an early stage and [...] Read more.
Hybrid clinical imaging is an emerging technology, which improves disease diagnosis by combining already existing technologies. With the combination of high-resolution morphological imaging, i.e., MRI/CT, and high-sensitive molecular detection offered by SPECT/PET/Optical, physicians can detect disease progression at an early stage and design patient-specific treatments. To fully exploit the possibilities of hybrid imaging a hybrid probe compatible with each imaging technology is required. Here, we present a hybrid nanoprobe for triple modality MR/SPECT/Fluorescence imaging. Our imaging agent is comprised of superparamagnetic iron oxide nanoparticles (SPIONs), labeled with 99mTc and an Alexa fluorophore (AF), together forming 99mTc-AF-SPIONs. The agent was stable in human serum, and, after subcutaneous injection in the hind paw of Wistar rats, showed to be highly specific by accumulating in the sentinel lymph node. All three modalities clearly visualized the imaging agent. Our results show that a single imaging agent can be used for hybrid imaging. The use of a single hybrid contrast agent permits simultaneous hybrid imaging and, more conventionally, allow for single modality imaging at different time points. For example, a hybrid contrast agent enables pre-operative planning, intra-operative guidance, and post-operative evaluation with the same contrast agent. Full article
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